Public health is under pressure. In healthcare systems around the world, funding is dwindling and exhausted specialists are leaving their jobs US state legislatures they withdraw needed legal authorities. At the same time, disease outbreaks such as measles and dengue are on the rise, increasing the urgency and responsibility of this work. In 2025, these pressures will trigger a transformation in epidemiology, forcing the adoption of innovations to raise efficiency and effectiveness in controlling epidemics.
The Covid-19 pandemic has presented an extremely tough challenge for public health workers, representing a historic response to the pandemic. The long-term crisis has exposed numerous labor shortages under enormous strain.
Unfortunately, the pandemic was not the first and will not be the last public health threat to breach our defenses. Historically, major infectious disease threats have occurred on average every two years. Even now, bird flu A(H5N1) has been expanding its geographical range and host species for years. According to some estimates, the world is now closer to a flu pandemic than any time recently.
In the face of these pressures, public health has no choice but to adapt. While novel technologies such as mRNA vaccine platforms and at-home testing are expanding our arsenal in the fight against epidemics, we cannot rely solely on these biomedical countermeasures.
The most significant untapped source of innovation is public health practice itself. The most promising development from these challenges is the adoption of higher reliability principles as the novel operating standard. These policies come from industries with zero tolerance for accidents and errors, such as space exploration and commercial aviation.
Public health, especially epidemiology, is beginning to move away from an individual approach to responding to epidemics towards structured processes typical of high-reliability industries. A commitment to continuous improvement, monitoring performance based on data and metrics, and implementing standard operating procedures are hallmarks of high reliability. These practices enable organizations to maintain security and effectiveness even in complicated environments where the stakes are high.
Although we are at the beginning of this transformation, the pressures of the last five years will accelerate the adoption of high reliability in the coming year. Some first successes are already noticeable. For example, the response program at CDC epidemics of foodborne diseases has made significant progress. They have aggressively deployed whole-genome sequencing to identify the sources of the outbreak and have developed a series of modeling best practices to support state and local officials in their investigations. This transformation has led to an raise in the number of successful investigations, meaning the sources of disease outbreaks are now more likely to be definitively identified. However, before these changes, the causes of many disease outbreaks remained unresolved.
Epidemiology is at a critical juncture. In the face of dwindling resources, staff burnout and rising disease outbreaks, the industry is being forced to innovate. Adopting high reliability principles borrowed from industries where failure is not an option seems to be a promising solution. This change is already showing results, as is research on foodborne illnesses. By using structured and continuously improved processes and cutting-edge technologies, public health will raise its ability to identify and control disease outbreaks. This transformation promises a more effective and effective approach to protecting public health in the face of evolving threats.